The Effects of Recent Welfare and Immigration Reforms on Immigrants’ Access to Health Care

This study investigates the impact of the Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act, both passed in 1996, on the use of health-care services in immigrant communities in five Texas counties. The study presents findings of interviews with public agency officials, directors of community-based organizations, and members of 500 households during two research phases, 1997–1998 and 1998–1999. In the household sample, 20 percent of U.S. citizens and 30 percent of legal permanent residents who reported having received Medicaid during the five years before they were interviewed also reported losing the coverage during the past year. Some lost coverage because of welfare reform restrictions on noncitizen eligibility or because of changes in income or household size, but many eligible immigrants also withdrew from Medicaid “voluntarily.”